Stock and Securities Donation
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1. For stock and securities donations, please print out this
page or download the PDF form. Fill
out the form and give it to your broker, or contact Elisa Dumitrescu
at (646) 742-8044, ext. 201, or info@blacksmithinstitute.org.
2. Please ask your broker to fax a copy of these stock donation
instructions to Elisa Dumitrescu at (212) 779-8044. In order
for Blacksmith Institute to confirm the receipt of your stock
gift, please include on the instructions your name, address,
telephone number, and e-mail address.
Brokerage Firm: |
________________________________ |
Broker: |
________________________________ |
Address: |
________________________________ |
| |
________________________________ |
Re: Account #: |
________________________________ |
Account Title: |
________________________________ |
Dear Broker:
Please accept this letter as authorization to gift:
_________ shares of _____________________ stock to:
Blacksmith Institute, a 501(c)(3) public charity
DTC number: 0418
Account number: 117-16541-12-009
Thank you for your immediate attention to this matter.
Sincerely,
____________________________
Signature of gifting share holder (donor) |
_______________________
Date |
PS: Please provide us with contact information for acknowledgment. |
Donor name: |
___________________________ |
Address: |
___________________________ |
| |
___________________________ |
Phone: |
___________________________ |
Fax: |
___________________________ |
Email: |
___________________________ |
* All contributions are tax-deductible as allowable by law. Blacksmith Institute is a registered 501 (c) 3 and a recognition letter/receipt will be sent following all contributions.
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